Family-based treatment with transition age youth with anorexia nervosa: a qualitative summary of application in clinical practice

Journal of Eating Disorders

Daniel Le Grange¹  James Lock²  Gail McVey⁶  Jennifer Couturier⁵  Brooke Allemang⁴  Victoria E Freeman³  Gina Dimitropoulos³ 

[1] Eating Disorders Program Department of Psychiatry and Department of Pediatrics, University of California, San Francisco, CA, USA;Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, CA, USA;Eating Disorders Program, University Health Network, 200 Elizabeth Street, Toronto M5G 2C4, ON, Canada;Sickle Cell and Thalassemia Transition Clinic, The Hospital for Sick children, Toronto, ON, Canada;Child and Adolescent Psychiatry, McMaster Children’s Hospital, Hamilton, Canada;Ontario Community Outreach Program for Eating Disorders, Toronto, ON, Canada

关键词: Developmental stage;    Parents;    Adolescents;    Family support;    Transition age youth;    Transition;    Qualitative research;    Family-based treatment;    Clinicians;    Anorexia nervosa;   

Others  :  1133295
DOI  :  10.1186/s40337-015-0037-3

 received in 2014-08-30, accepted in 2015-01-12,  发布年份 2015

【 摘 要 】

Background

Family based treatment (FBT) has been empirically investigated in adolescents between the ages of 12 and 19 years of age. Although parental control over eating symptoms and the weight gain process are temporary and necessary due to serious medical complications, FBT may be developmentally inappropriate when working with older adolescents. To date, there are no studies identifying how the principles of this model are used differentially across different stages of adolescence. This study aimed to identify how clinicians informed by FBT employ this model with transition age youth (TAY) (16–21) with an eating disorder.

Methods

Using content analysis, seven individual interviews and six focus groups were conducted with 34 clinicians from specialized Eating Disorder Treatment programs across Ontario, Canada.

Results

Participants consistently reported modifying FBT to increase its developmental appropriateness with TAY in the following ways: working more collaboratively with the patient, increasing individual time spent with the patient prior to the family meeting, providing greater opportunities for the individual to practice eating without parental support and introducing relapse prevention in the latter phase of the treatment.

Conclusions

In all adaptations of the model, participants in focus groups and individual interviews cited the age of the individual with the eating disorder, their level of autonomy and independence in all areas of their lives, and their pending transfer of care from paediatric to adult eating disorder programs as main factors that influenced the modification of FBT with TAY. While adaptations were made across all three phases of FBT, adherence to the model progressively declined over the course of treatment with adaptations increasing significantly in the later phases. Future research is needed to evaluate the effectiveness of an adapted version of FBT with TAY.

【 授权许可】

   
2015 Dimitropoulos et al.; licensee BioMed Central.

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